Two-photon imaging of cell-specific fluorophores in transgenic mice – an exploratory tool to study mechanisms of white matter injury

Relatively little is known about specific pathways leading to structural and functional disruption of axons and glial cells in white matter. Because focal cerebral ischemia in humans damages both gray and white matter, an understanding of white matter injury is important in devising potential therapeutic approaches. We have developed a novel brain slice model from transgenic mice under control of cell-specific promoters to understand interactions between oligodendrocytes and axons under high resolution twophoton microscopy. Our data extends over previous findings the vulnerability of oligodendrocytes and axons both in culture and in slice preparations to glutamate toxicity during stroke and hypoglycemia. Conditions as different as stroke, trauma, perinatal brain injury, and multiple sclerosis may share common mechanisms of white matter injury.N/

The standard error of measurement is a more appropriate measure of quality for postgraduate medical assessments than is reliability: an analysis of MRCP(UK) examinations

Background: Cronbach's alpha is widely used as the preferred index of reliability for medical postgraduate examinations. A value of 0.8-0.9 is seen by providers and regulators alike as an adequate demonstration of acceptable reliability for any assessment. Of the other statistical parameters, Standard Error of Measurement (SEM) is mainly seen as useful only in determining the accuracy of a pass mark. However the alpha coefficient depends both on SEM and on the ability range (standard deviation, SD) of candidates taking an exam. This study investigated the extent to which the necessarily narrower ability range in candidates taking the second of the three part MRCP(UK) diploma examinations, biases assessment of reliability and SEM.Methods: a) The interrelationships of standard deviation (SD), SEM and reliability were investigated in a Monte Carlo simulation of 10,000 candidates taking a postgraduate examination. b) Reliability and SEM were studied in the MRCP(UK) Part 1 and Part 2 Written Examinations from 2002 to 2008. c) Reliability and SEM were studied in eight Specialty Certificate Examinations introduced in 2008-9.Results: The Monte Carlo simulation showed, as expected, that restricting the range of an assessment only to those who had already passed it, dramatically reduced the reliability but did not affect the SEM of a simulated assessment. The analysis of the MRCP(UK) Part 1 and Part 2 written examinations showed that the MRCP(UK) Part 2 written examination had a lower reliability than the Part 1 examination, but, despite that lower reliability, the Part 2 examination also had a smaller SEM (indicating a more accurate assessment). The Specialty Certificate Examinations had small Ns, and as a result, wide variability in their reliabilities, but SEMs were comparable with MRCP(UK) Part 2.Conclusions: An emphasis upon assessing the quality of assessments primarily in terms of reliability alone can produce a paradoxical and distorted picture, particularly in the situation where a narrower range of candidate ability is an inevitable consequence of being able to take a second part examination only after passing the first part examination. Reliability also shows problems when numbers of candidates in examinations are low and sampling error affects the range of candidate ability. SEM is not subject to such problems; it is therefore a better measure of the quality of an assessment and is recommended for routine use

GPAQ-R: development and psychometric properties of a version of the general practice assessment questionnaire for use for revalidation by general practitioners in the UK.

BACKGROUND: The General Practice Assessment Questionnaire (GPAQ) has been widely used to assess patient experience in general practice in the UK since 2004. In 2013, new regulations were introduced by the General Medical Council (GMC) requiring UK doctors to undertake periodic revalidation, which includes assessment of patient experience for individual doctors. We describe the development of a new version of GPAQ - GPAQ-R which addresses the GMC's requirements for revalidation as well as additional NHS requirements for surveys that GPs may need to carry out in their own practices. METHODS: Questionnaires were given out by doctors or practice staff after routine consultations in line with the guidance given by the General Medical Council for surveys to be used for revalidation. Data analysis and practice reports were provided independently. RESULTS: Data were analysed for questionnaires from 7258 patients relating to 164 GPs in 29 general practices. Levels of missing data were generally low (typically 4.5-6%). The number of returned questionnaires required to achieve reliability of 0.7 were around 35 for individual doctor communication items and 29 for a composite score based on doctor communication items. This suggests that the responses to GPAQ-R had similar reliability to the GMC's own questionnaire and we recommend 30 completed GPAQ-R questionnaires are sufficient for revalidation purposes. However, where an initial screen raises concern, the survey might be repeated with 50 completed questionnaires in order to increase reliability. CONCLUSIONS: GPAQ-R is a development of a well-established patient experience questionnaire used in general practice in the UK since 2004. This new version can be recommended for use in order to meet the UK General Medical Council's requirements for surveys to be used in revalidation of doctors. It also meets the needs of GPs to ask about patient experience relating to aspects of practice care that are not specific to individual general practitioners (e.g. receptionists, telephone access) which meet other survey requirements of the National Health Service in England. Use of GPAQ-R has the potential to reduce the number of surveys that GPs need to carry out in their practices to meet the various regulatory requirements which they face

Robert E. Tranquada Papers, 1979-2009: A Finding Aid

The Robert E. Tranquada Papers chronicle Tranquada’s role as Chancellor and Dean of the University of Massachusetts Medical School

Oral History Collection: A Finding Aid

The Oral History Collection comprises transcripts of interviews conducted from 2006 to 2015 by Ellen S. More, Ph.D., founding director of Lamar Soutter Library’s Office of Medical History and Archives (OMHA) at the University of Massachusetts Medical School (UMMS). The interviews were conducted as part of Dr. More’s research into the history of UMMS, which is chronicled in her book, Beating the Odds: The University of Massachusetts Medical School, A History, 1962–2012 (2017). Interviewees include former and current members of the administration, faculty, staff, students, politicians, and community members

Graduate School of Nursing Papers, 1982 – 2010: A Finding Aid

The Graduate School of Nursing Papers documents the establishment of the Graduate School of Nursing at the University of Massachusetts Medical School, and chronicles its early history and development

James P. Loughlin Papers, 1965-1979: A Finding Aid

The James P. Loughlin Papers chronicles Loughlin’s career as a labor union leader in Massachusetts and the role he had in locating the University of Massachusetts Medical School and its affiliated hospital in Worcester

Office of Ethics Records, 1977-1999: A Finding Aid

The records in this collection from the University of Massachusetts Medical School consist of documents, correspondence, publications, and other materials created by the Office of Ethics between 1977 and 2000

Memorial Hospital Collection, 1873 – 1990: A Finding Aid

The Memorial Hospital Collection comprises annual reports and other material by or about The Memorial Hospital in Worcester, Massachusetts